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EBMT 2025 | Key factors when considering stem cell transplantation for an older patient with AML
In this video, Nelli Bejanyan, MD, Moffitt Cancer Center, Tampa, FL, briefly outlines some key factors to consider when deciding whether an older patient with acute myeloid leukemia (AML) is a suitable candidate for stem cell transplantation (SCT). Dr Bejanyan emphasizes the need for an individualized assessment of disease-relevant, transplant-relevant, and patient-relevant factors. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.
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Transcript
Unfortunately, not all older patients are candidates for allogeneic transplantation. We have safer platforms available nowadays, both from the standpoint of conditioning regimens as well as GvHD prophylaxis, such as PTCy-based GvHD prophylaxis has revolutionized how we approach patients with a low risk of non-relapsed mortality.
However, this is still not therapy for everyone...
Unfortunately, not all older patients are candidates for allogeneic transplantation. We have safer platforms available nowadays, both from the standpoint of conditioning regimens as well as GvHD prophylaxis, such as PTCy-based GvHD prophylaxis has revolutionized how we approach patients with a low risk of non-relapsed mortality.
However, this is still not therapy for everyone. We take into account comorbidities that are present at the time of transplantation, as well as the Karnofsky performance status from a patient selection standpoint. But also, disease relevant factors are important as well, such as patients who have high-risk genetic mutations, such as those with TP53 mutation, for example, particularly if patients are MRD positive pre-transplant, we know that routine reduced-intensity, even more so non-myeloablative conditioning regimen, is unlikely to provide curative therapy to these patients. So, therefore, for each individual case, we need to look into more details in terms of disease-relevant factors, transplant-relevant factors, and more importantly, patient-relevant factors as well.
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Disclosures
Consultancy or advisory role: CareDx, Medexus Pharmaceuticals, ORCA Biosystems, AlloVir, TScan Therapeutics, Pfizer; Research funding: CRISPR Therapeutics.
